On the surface, the article reads like a science-journalism bombshell indeed. Apparently a lead researcher involved in the development of Merck’s human papilloma virus (HPV) vaccine Gardasil claims that the vaccine is essentially useless in preventing cervical cancer, and has not been adequately tested in girls under 15 despite its widespread use in this group. However, a bit of research into the individuals and organizations involved in this story yields a Byzantine web of connections between the Christian anti-abortion, anti-birth control lobby and the anti-vaccine community worthy of a Dan Brown novel.

It is interesting that the event at which Dr. Harper allegedly dropped her “bombshell” was the 4th International Public Conference on Vaccination. This is a faux scientific meeting organized by the National Vaccine Information Center (NIVC). The NIVC is to the anti-vaccine movement as the Discovery Institute is to the Intelligent Design movement. It is a well-organized and well-funded group that strives to give the patina of scientific legitimacy to unfounded and irrational opposition to vaccination. The speakers at this meeting included Andrew Wakefield, the father of the vaccines-cause-autism myth, Richard Pitcairn, the founding father of veterinary homeopathy and the leading veterinary anti-vaccine advocate, and a long list of others with a decidedly hostile attitudes towards vaccination. Again, it is unclear whether Dr. Harper felt that speaking at such an event was a chance to argue for vaccination against HPV in “hostile territory” (as the article contends) and she simply did so badly, or if she chose to speak in a forum where she knew any criticism of any vaccine would be warmly received.

The gist of Dr. Harpers comments as reported in the article is that HPV rarely leads to cervical cancer and that current detection and treatment regimes are so effective that the vaccine adds little to the fight against cervical cancer. She was also quoted as say “The rate of serious adverse events is greater than the incidence rate of cervical cancer.” If true, this would indeed be a strong case against vaccination for HPV.

I do not have adequate information to say with certainty whether this case is in fact as strong as the article suggests, but I am skeptical. The CDC presents information that directly contradicts some of the statements attributed to Dr. Harper and gives a strong recommendation in favor of vaccination, so it would surprise me if there was in fact such an obvious slam dunk argument against the HPV vaccine. In any case, I’m hoping the folks over at Science Based Medicine will offer a fact-based perspective on this soon.

The article is also questionable in following the common misleading strategy of citing large numbers of adverse events reported following HPV vaccinations without acknowledging that the overwhelming majority of these are never demonstrated to be caused by the vaccine. It even goes so far as to refer to the case of Natalie Morton, a young girl in England who died shortly after receiving an HPV vaccine. Despite the misleading initial media reports, it is clear that her death was due to a malignant tumor and had nothing to do with the vaccine. The author does not bother to mention this fact in her article, which raises further questions about the accuracy and objectivity of her reporting.

The plot thickens, then, when we look into the background of the journalist who authored the article, Susan Brinkmann. Ms. Brinkmann is a member of the Secular Order of the Discalced Carmelites, which is a group of lay Catholics who are affiliated with and adhere to many of the rules and practices of the nuns and friars who are primary members of the order. Interestingly, she is also the author of The Kinsey Corruption, a book which argues that Alfred Kinsey was a “committed atheist…[who] was determined to undermine the traditional moral climate of America and pave the way for the widespread acceptance of all kinds of perversity, including pedophilia and bestiality,” and which blames the current state of moral “decay” in American on the loss of “traditional” values regarding sexuality. Ms. Brinkman has also written extensively opposing abortion, homosexuality and birth control. One does have to wonder, then, if the apparently damning case against HPV vaccination presented in her article is objective and truthful or perhaps influenced by a concern sometimes expressed among conservative Christians that vaccination might encourage sexual activity among adolescent girls.

Another figure in the article, who is quoted three times emphasizing that Dr. Harper’s talk made the case that the HPV vaccine is unnecessary, is Joan Robinson of the Population Research Institute. This organization is a coalition of pro-life groups founded by a Catholic priest with the goal to, as their mission statement says:

“Debunk the myth of overpopulation, which cheapens human life and paves the way for abusive population control programs

Once again, the damning case against HPV vaccination is made by someone who (coincidently?) opposes birth control, abortion, and other medical interventions to reduce the risks of sexual activity. Hmmm….

This article has the potential to raise troubling questions about the safety and efficacy of HPV vaccination in the minds of reasonable people. However, the case made by the author begins to unravel with relatively little probing into the facts presented and the agendas of the individuals and organizations involved. Such research makes it clear that the anti-vaccine movement, which opposes HPV vaccination for all the usual irrational reasons and despite unequivocal evidence that they are wrong, and conservative Christians, who appear to oppose anything that might make having sex safer, have banded together to spread fear and misinformation about HPV vaccination.

As frightening an alliance as this might be, I fear it cannot last. Though research shows CAM providers to be somewhat more religious in temperament that some scientific medicine providers, they tend to be less committed to a specific religion and more inclined towards vague New Age varieties of spirituality. Among Ms. Brinkman’s writings, however, is the book Learn to Discern: Is it Christian or New Age which warns against the dangerous influence and likely demonic nature of some New age practices. I suspect the opposition to HPV vaccination will be a short-lived marriage of convenience between conservative Catholics and the pro-CAM, anti-vaccine fringe.

Dr. Harper’s role in the story is less clear. Given her credentials as a researcher into HPV and a proponent in many cases of HPV vaccination, I am inclined to take her concerns more seriously than those of NVIC or the Catholic Church. However, her choice to speak at the NVIC meeting, and her comments if they are represented accurately, diminishes her credibility. I suspect there are even more layers of intrigue beneath the surface that I have been unable to penetrate.

In any case, this article, and the unraveling of some of the personalities and hidden agendas behind it, is an excellent example of the unreliability of so much “science journalism.” It is understandable, and sad, that people unable to look deeper into such media reports will be mislead by them, and the resultant fear and confusion can lead to poor decision making. The anti-vaccine movement relies on spreading such fear and confusion, and they are skilled at doing so. Those of us committed to giving people truthful and objective information to use in making healthcare decisions have an obligation to reveal the reality behind the smoke and mirrors of propaganda like Ms. Brinkman’s article, and to encourage and support the work of real science journalists.

The Skeptical OB, Amy Tuteur, found more complete quotations from Dr. Harper’s address which illustrate the point she intended to make and how the journalist took what she said out of context to spin it into an indictment of Gardasil. Below is her comment:

“The doctor was misquoted.

Dr. Harper said:

“In developed countries where Pap screening systems have been effective for decades, the biggest value of the HPV vaccine will not be in preventing DEATHS from cervical cancer.” (my emphasis)

That’s because routine Pap smears identify precancerous cells that can be treated before they become cancerous, and identify early cancers that can be effectively treated with radical hysterectomy.

So while deaths will not decrease, we can look forward to a dramatic decrease in the number of cervical laser procedures for precancerous cells, and a dramatic decrease in the number of radical hysterectomies.

Sure, we could forget about preventing cervical cancer and just treat it when it develops (continuing to enrich the gyn oncologists) or we could prevent it with the vaccine. Prevention is better than even the most successful treatment.

Moreover, Dr. Harper reports that she has received money from both Merck and GlaxoSmithKline for consultation about and conducting clinical trials on the HPV vaccines. Her overall impression of the vaccine:

Good to see that Dr. Harper was misquoted, sadly an all too common occurrence.
It always amazes me that when people want to avoid something like Gardasil for their own religious reasons, they can’t leave it at that, but want to deprive everyone else of a potential benefit as well. Why is the Establishment Clause so difficult to understand? I haven’t heard anything about making Gardasil mandatory, just recommended-don’t get it if you don’t want it, but don’t lie and distort the evidence to try to eliminate it.

Some states have considered making it mandatory (apparently Texas did consider it due to high rates of teen sex) but even then would have had some type of waiver. It seems to be the same type of religious denialism-“my child could not be at risk of contracting an STD”. Even when statistics show that a large percentage of high school students are sexually active.http://pediatrics.about.com/od/immunizations/a/0207_hpv_school.htm

I don’t know that any states have made it mandatory, especially after the fear and religiously-based protests. Here in Arizona, it is available at low cost from county health departments, but is not mandated by the schools. I suspect many less kids are getting it as it involves three trips to the health department on a parents initiative. If the evidence of safety and effectiveness is there (orac is concerned about the high cost of the vaccine and questions it’s cost-effectiveness) giving it at school, even if it is optional is probably a good idea.